 WHAT TO BRING TO YOUR APPOINTMENT (FIRST VISIT)
• Your completed registration forms
Be sure to bring your completed patient information forms. Completing these forms prior to your appointment date gives you the time to gather necessary information and makes your wait to see the doctor shorter.
Click on a link below to download the form to your computer.
• Download SNSI Patient Registration Form
• Download SNSI Patient Questionnaire Form
• Download SNSI Review of Systems Form
• Download SNSI Consent Disclosure Form
• Download SNSI Policies & Procedures
• If you are having an MRI exam at Southern Medical Imaging:
Download SMI Patient Registration Form
YOUR CURRENT INSURANCE CARD(S) AND CO-PAY OR COINSURANCE
YOUR DRIVER’S LICENSE OR PHOTO ID
BRING ALL MRI AND X-RAY FILM AND /OR CD’S THAT PERTAIN TO
YOUR CURRENT ILLNESS
FINANCIAL POLICY
We accept the following forms of payments: cash, check, MasterCard, Visa, Discover, American Express, and debit cards.
Thank you for choosing us as your health care provider. We are committed to providing you with the finest health care available and courteous helpful staff. This service begins from the time you check in at our reception desk to the final payment of your bill.
We also offer and accept CareCredit patient payment plans. CareCredit is the leader in patient financing. Upon approval, CareCredit offers a comprehensive range of plans with low minimum monthly payments that fit comfortably into every budget. No interest and low interest payment plans that can be used repeatedly for yourself, your entire family, and even you pets.
For more information visit www.carecredit.com
OFFICE VISITS
Payment in full for all office visits is expected on the day of your appointment unless you have applicable insurance that will be filed for your visit. Co-pays, deductibles and co-insurance amounts will be collected before you are seen by the physician. Failure to pay your co-pay or co-insurance, or at least a partial amount, could possibly result in your appointment being rescheduled.
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